By Katie Bailey and Joti Kaur
Researchers from the Indiana University Public Policy Institute will conduct process and outcome evaluations of the city’s newly-adopted Mobile Crisis Assistance Team, also known as M-CAT. Indianapolis Mayor Joe Hogsett announced the formation of the crisis team earlier this month.
Like several other cities across the county, Indianapolis is aiming to divert people with a mental illness from the cycle of incarceration at the earliest point of the criminal justice system: arrest. To accomplish this, the Office of Public Health and Safety has collaborated with the Indianapolis Metropolitan Police Department, Indianapolis Emergency Medical Services, and Eskenazi Midtown Community Mental Health to pilot M-CAT.
In the United States, the rate of serious mental illness (i.e., schizophrenia, bipolar disorder, or major depression) in jail and prison is five times greater than the proportion of serious mental illness in the general population. In fact, more people with mental illness are being treated in jails and prisons than in public psychiatric hospitals. Consistent with these national trends, the disproportionate representation of those with mental illness in jail and prison is also a concern in Central Indiana.
The intent of the M-CAT program is to divert people, when appropriate, away from jail and hospitalization by addressing the issue at the scene of a 911 call and referring them to necessary treatments and services. The M-CAT is based on an Integrated Health Care model, combining the expertise of an officer, paramedic and crisis-specialized clinician to respond to legal, behavioral health, substance abuse, and medical crises in one vehicle.
There will be four M-CAT teams and they will dispatch at the request of a first-responding IMPD officer or IEMS medic. Teams also have the discretion to self-dispatch as 911 calls come through the radio. The program intends to:
- Minimize the use of force and injury to individuals, families, and public safety personnel during a crisis;
- Reduce the number of arrests of citizens with a behavioral health or substance use problem;
- Relieve first-respondent ambulance and IMPD units so they can quickly return to service after M-CAT assumes responsibility for the scene;
- Reduce the number of EMS encounters among households that frequently resort to 911 calls; and,
- Link people with appropriate health, substance use, and behavioral health treatment and social services.
Research suggests that such interventions can save substantial dollars because, 1) emergencies are handled with greater coordination and in less time; 2) fewer emergency response vehicles are necessary to stabilize a crisis situation; and, 3) citizens are diverted from jail and hospitalization whenever possible as teams like M-CAT address needs on the scene and prepare a safety plan and follow-up schedule.
PPI’s process evaluation will carefully track and study the way in which the M-CAT addresses crises by analyzing data from runs, in-depth interviews and focus groups with M-CAT team members, and observations conducted during ride-alongs. The outcome evaluation will test the effectiveness of the M-CAT by generating a comparison group of similar emergency calls for service from another IMPD district (where the M-CAT does not operate).
PPI will evaluate whether the M-CAT model results in fewer arrests and hospitalizations, quicker and more frequent alleviation of other emergency response vehicles, as well as changes in the utilization of 911 emergency calls.
The pilot program will take place over six months during which PPI will collect all necessary data for evaluation purposes. Upon completion of the pilot, PPI will complete the outcomes analysis to determine whether the pilot program was successful, and which aspects of it were the most impactful. Should the M-CAT prove to be successful, the data collection and process tracking will provide a model that can be replicated in other parts of Indianapolis, the state, and nation.
